Prevalence of lower limb peripheral arterial disease in angiograhically proven coronary disease in kashmir region

Background: Peripheral artery disease (PAD) is under diagnosed, undertreated, poorly understood, and much more common than previously thought. In primary care practices across the United States, 29% of patients who are older than 70 years or who are older than 50 years with a history of smoking or diabetes have been reported to have PAD. Objectives: (i)To assess prevalence of lower limb peripheral arterial disease in patients with angiographically proven coronary artery disease, (ii) to see the relation between severity of coronary artery disease and peripheral arterial disease, and (iii) to study risk factor profile of peripheral arterial vis-à-vis coronary artery disease. Methodology: This was a prospective hospital based study conducted in the Department of Cardioogy at SKIMS, Soura, Srinagar, Kashmir. All the patients who were taken for coronary angiography in the Department of Cardiology, SKIMS, Srinagar were evaluated in terms of complete relevant history, clinical examination and laboratory investigation. The clinical symptoms like intermittent claudication, resting, pain, feeling of cold or numbness in toes were enquired. To ascertain the presence of intermittent claudication Edinburgh Claudication Questionnaire (ECQ) was administered. Results: There were 69 males and 33 females with male female ratio of 2.1:1. Mean age of population was 59.5+ 9.1years. Prevalence of peripheral arterial disease was 13.7% as documented by peripheral angiography. Claudication was the only relevant symptom present in two patients (14.3%) with peripheral arterial disease as compared to none without peripheral arterial disease. Hypertensive patients were more likely to have peripheral arterial disease as it6 was present in 71.4% among patients with peripheral arterial disease. Diabetics were more likely to have peripheral arterial disease as it was present in 42.9% among patients with peripheral arterial disease. Family history of coronary artery disease was equally distributed in both groups. Conclusion: Coronary artery disease evaluation should be considered in patients with lower extremity PAD having diabetes, multi-cardiovascular risk factors, or multi-level disease.